Diagnosis and Treatment planning Flashcards
Goals
* To analyze the —
* To diagnose the —
* To establish a —
* To pick up —
* To use the “— “ principle
* To assess the necessary —
* To set the basis for the future —
present malocclusion
malocclusion
differential diagnosis
clues
inside out
changes
correction
Make sure to address the
— of the
patient. Not necessarily to
treat it but aknowledg and
discuss options
chief complaint
❖PAST MEDICAL HISTORY:
❖Some medical conditions have an impact on
orthodontic treatment.
❖ MEDICATIONS:
❖ Some medications may interfere with bone
remodeling (Biphosphonates)
❖ALLERGIES:
❖Affect breathing and neuromuscular function
❖ORAL HYGIENE:
Good- Fair- Poor
❖Determine Facial type:
❖ Goal is to determine the facial type ( Clue for the
complexity of malocclusion)
❖Facial proportions:
Raito
* Contributes to
* The most important for us is the
55:45 (UFH:LFH)
facial harmony
lower face height.
❖Determine Facial symmetry
(2)
❖Mandibular deviation
❖Unfavorable growth patterns
❖How is the Facial profile?
(4)
❖Convex
❖Flat - Straight
❖Concave
Helps determine the maxilla- mandible relationship and
the position of the jaws in the antero posterior plane
❖The Nasolabial angle is
(4)
❖Acute
❖Normal
❖Obtuse
Gives an indication on the position of the upper incisors
❖Lips:
(4)
❖ Length
❖ Seal
❖ Strain
❖ Harmony of lip position is very important for esthetic and
functional success
Neuromuscular and
TMJ Examination
(4)
❖ Tongue at rest:
❖ Swallowing pattern:
❖ Muscles of mastication:
❖ TMJ
❖ Swallowing pattern:
◼ Normal or infantile swallowing
❖ Muscles of mastication:
❖ Palpation of masseters and temporalis muscles
❖ TMJ:
❖ Always perform a TMJ screening prior to any
orthodontic intervention. Keep inquiring
during treatment
Extra-oral → Intra-oral
❖ Facial Midlines?
(4)
❖ Upper Dental Midline
❖ Lower dental midline
❖ Mandibular midline
❖ Help position teeth and jaws
in the transverse palne
Overbite:
(3)
❖ Skeletal-
Dentoalveolar?
❖ Incisor extrusion?
❖ Molar lack of
eruption?
Overjet: mm
(2)
❖ Skeletal- SNA-
SNB?
❖ Dental:
Proclination of
incisors?
Teeth present:
◼ Maxilla:
◼ Mandible:
Assess the potential need for (2)
Important in adult patients presenting with
restorative work or space closure
missing teeth.
Determine Arch shape:
(3)
◼ Upper:
◼ Lower
◼ Helps in determining if expansion
or if crowding can be alleviated by
orthodontic without extractions
Intra-Oral Examination
❖Clinical findings:
(5)
- Oral hygiene
- Existing restorations
- Need for operative works before ortho.
- Periodontal condition
- General idea of the occlusion
Amount of crowding:
No crowding, mild crowding, moderate crowding and
severe crowding
- Clue: Dentoalveolar expansion
- Interproximal reduction
- Extractions
skipped
Panoramic Radiograph Analysis
Significant Findings:
(7)
- TMJ screening
- Missing teeth
- Pathologies
- Impacted Teeth
- Perio screening
- Gross decay
- General mandibular
shape - …..
Dental Cast Analysis:
Curve of Spee
❖ Upper:
(1)
❖ Position of the
dentition in relation
to the occlusal plane
Dental Cast Analysis:
Curve of Spee
❖ Lower:
Sign of a severe malposition of
the dentition in the —
plane ?
Curvature of the alignment of
the lower dentition.
vertical
Dental Cast Analysis: Tooth size
Bolton analysis – ideally –%
77
Are teeth too small,
too large?
Is the upper and
lower dentition
proportional to insure
good —
Ratio length to width
interdigitation
